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National Asthma and COPD Audit Programme (NACAP): secondary care workstream - COPD

What we are doing

The COPD secondary care workstream comprises two parts: a continuous clinical audit of people admitted to hospital in England, Scotland (from late 2018) and Wales with COPD exacerbations, and a snapshot audit of the organisation and resourcing of care. 

Participation in the secondary care workstreams of the National Asthma and COPD Audit Programme (NACAP) is a requisite of trust quality accounts.

The COPD continuous clinical audit was initiated under the auspices of the National COPD Audit Programme in February 2017.

A new clinical report was published on 9 May 2019 which presents key process and short-term outcome measures for patients discharged from hospital between September 2017 and September 2018.

Two previous reports have been published, COPD: Time to integrate care and COPD: Working together which present secondary care organisational audit data and clinical data respectively. An addendum to COPD: Working together has also been published (available at the above link) which presents longer-term outcome (30- and 90-day readmission and mortality) data for that patient cohort. 

For both of the above reports, a quality improvement (QI) slide set focused on the key findings from the 2017 audits is also available.

Continuous clinical audit

This audit aims to collect information on all people admitted to hospital with COPD exacerbations. Admission data, obtained from patient case notes, are being collected by participating hospitals, and the data entered into a secure and bespoke audit web tool.

A partially revised dataset launched on 1 October 2018. The updated dataset has been published on both the web tool and the workstream resources page along with updated guidance documents. Please note these changes do not impact upon the best practice tariff (BPT).

Organisational audit

A snapshot organisational audit was launched on 1 April 2019 and ran until 1 July 2019. In an effort to reduce clinical burden and duplication of effort this ran as a combined COPD and adult asthma organisational audit with data collection via the bespoke audit web tool. Data on the resourcing and organisation of services was collected; the dataset for this audit is still available on the COPD resources page for information purposes. A national organisational audit report, based on an analysis of the data collected, is due to be launched in Spring 2020.

The secondary care audit also has a programme page on the Respiratory Futures website, as well as a forum where healthcare professionals can share learning about doing and learning from the audit.

Uses of COPD audit data

Best practice tariff (BPT)

Two audit indicators within the clinical dataset form the basis of a COPD best practice tariff (within the national tariff for 2017–18 and 2018–19). This was introduced in April 2017:

  • specialist review within 24 hours
  • BTS, or equivalent, discharge bundle for admission.

For all other uses of COPD audit data please refer to the 'uses of data' document which can be downloaded from the COPD audit resources page.

COPD secondary care good practice repository

The National Asthma and COPD Audit Programme (NACAP) has collated a series of case studies which highlight good practice in audit data collection and entry, and in provision of quality COPD care. These can be accessed via the dedicated good practice repository webpage.

Audit timeline

  • March 2018 – February 2021: continous clinical data collection
  • March-October 2018: recruitment of Scottish hospitals
  • October 2018: launch of audit in Scotland
  • Summer 2019, 2020 and 2021: planned publication of national clinical report
  • April 2019 - February 2020: COPD and asthma adult organisational audit
    • 1 April – 1 July 2019: data collection
    • July 2019 – February 2020: analysis and report preparation
  • February 2020: planned publication of COPD and asthma adult national organisational report

The above timeline may be subject to change but we will keep you updated regarding any changes and provide additional timeline details as they are confirmed.


If you think your data may have been collected as part of this audit and wish to have it removed, then please speak to a member of your respiratory team at the hospital that treated you, or contact a member of the audit programme team by email at copd@rcplondon.ac.uk or phone on +44 (0)20 3075 1526.

Who's involved


All relevant secondary care providers in England and Wales, and Scotland from late 2018, are expected to participate. NACAP is included in the list of national audits for inclusion in trusts’ quality accounts, and is also included in the NHS Wales clinical audit and outcome review plan.

What we have produced

COPD clinical audit 2018/19 is the third clinical audit report post launch of continuous data collection (on 1 February 2017). It presents data describing the cohort of patients discharged between 1 October 2018 and 30 September 2019.

The adult asthma and chronic obstructive pulmonary disease (COPD) organisational audit report 2019 is the first published organisational audit report following the launch of the National Asthma and COPD Audit Programme (NACAP) in March 2018.

COPD clinical audit 2017/18 is the second report post launch of continuous data collection on 1 February 2017.

Information and resources developed to help organisations participating in the NACAP secondary care (COPD) workstream.
The National Asthma and COPD Audit Programme (NACAP) has collated a series of case studies which highlight good practice in audit data collection and entry, and in provision of quality COPD care. 
England and Wales case ascertainment for the COPD secondary care audit.